Objective To explore the role of baseline interleukin 1β （IL-1β） and interleukin 6 （IL-6） levels in predicting the efficacy of non-convulsively modified electroconvulsive therapy （MECT） for Geriatric depression with suicidal ideation. Methods A total of 58 elderly patients with depression admitted to the Geriatric Psychiatric Department of Beijing Anding Hospital Affiliated to Capital Medical University from June 1st， 2021 to May 31th， 2022 were included in this project. All patients had suicidal ideation （the score of the Self-rating Idea of Suicide Scale ≥ 12 points） and received 5-8 MECT treatment. Blood samples， demographic data and clinical symptom evaluation data were collected before treatment and 2 weeks after treatment， and baseline levels of IL-1β and IL-6 were measured. Cut-off value of baseline IL-6 level was analyzed using receiver operating characteristic （ROC） curves. Binomial Logistic regression model was used to analyze the relationship between baseline level of IL-6 and clinical efficacy. Results After 2 weeks of MECT treatment， 53.4% （31/58） of patients showed effective treatment， while 46.6% （27/58） of patients showed ineffective treatment； 89.7% （52/58） of patients had undetectable IL-1β. The proportion of male patients in the effective group was lower than that in the ineffective group ［25.8% （8/31） vs 51.9% （14/27）］， and baseline IL-6 level was higher than those in the ineffective group ［10.11 （0， 38.94） pg/ml vs 0 （0， 6.46） pg/ml］， with statistically significant differences（χ2 =4.158， Z=-2.925； P ＜ 0.05）. The area under the ROC curve for predicting the efficacy of MECT with baseline IL-6 level was 0.714 （95%CI=0.576 to 0.852）， and the cut-off value of baseline IL-6 level was 7.49 pg/ml. The sensitivity and specificity for predicting efficacy were 0.677 and 0.815， respectively. Binomial Logistic regression analysis showed that male （OR=0.147， 95%CI=0.025 to 0.874， P ＜ 0.05） and baseline IL-6 level ≥ 7.49 pg/ml （OR=17.261， 95%CI=2.966 to 100.440， P ＜ 0.01） were effective risk factors for MECT treatment in elderly depression patients with suicidal ideation. Conclusions In the treatment of geriatric depression with suicidal ideation， there is a certain relationship between serum baseline IL-6 level ≥ 7.49 pg/ml and MECT efficacy， which can be used to predict the prognosis of elderly depression patients with suicidal ideation.